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Okumi M, Kujime Y, Matsumura S, Kitakaze H, Nakano K, Hongo S, Yoshioka I, Takada S. Multimodal therapy including robot‐assisted radical cystoprostatectomy for locally advanced prostate cancer with bladder and ureteral invasion: A case report. IJU Case Rep 2022; 5:402-405. [PMID: 36090930 PMCID: PMC9436667 DOI: 10.1002/iju5.12500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/12/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction It remains unclear whether robot‐assisted radical cystoprostatectomy for locally advanced prostate cancer represents excessive treatment. Case presentation A 58‐year‐old man presented with urinary retention and renal failure. Prostate‐specific antigen level was 38.07 ng/mL and computed tomography scans revealed bilateral hydronephrosis due to prostate enlargement. Prostate biopsy revealed a Gleason score of 5 + 5 adenocarcinoma, and bilateral hydronephrosis persisted even after urethral catheter placement. We diagnosed locally advanced prostate cancer with bladder and ureteral invasion. Percutaneous bilateral nephrostomy was performed, and neoadjuvant hormone therapy was initiated. Four months after the start of hormone therapy, robot‐assisted radical cystoprostatectomy and an intracorporeal ileal conduit were performed, followed by adjuvant radiation therapy for lymph node metastasis. Seven months after the surgery, the patient was free of disease with prostate‐specific antigen level <0.03 ng/mL. Conclusion Robot‐assisted radical cystoprostatectomy can be an effective multimodal therapy for locally advanced prostate cancer with bladder and ureteral invasion by locally advanced prostate cancer.
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Affiliation(s)
| | - Yuma Kujime
- Department of Urology Osaka Police Hospital Osaka Japan
| | | | | | - Kosuke Nakano
- Department of Urology Osaka Police Hospital Osaka Japan
| | - Sachiko Hongo
- Department of Urology Osaka Police Hospital Osaka Japan
| | - Iwao Yoshioka
- Department of Urology Osaka Police Hospital Osaka Japan
| | - Shingo Takada
- Department of Urology Osaka Police Hospital Osaka Japan
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Miyasaka Y, Kawamura H, Sato H, Kubo N, Mizukami T, Matsui H, Miyazawa Y, Ito K, Nakano T, Suzuki K, Ohno T. Carbon ion radiotherapy for prostate cancer with bladder invasion. BMC Urol 2021; 21:106. [PMID: 34362355 PMCID: PMC8349048 DOI: 10.1186/s12894-021-00871-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 07/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background The optimal management of clinical T4 (cT4) prostate cancer (PC) is still uncertain.
At our institution, carbon ion radiotherapy (CIRT) for nonmetastatic PC, including tumors invading the bladder, has been performed since 2010. Since carbon ion beams provide a sharp dose distribution with minimal penumbra and have biological advantages over photon radiotherapy, CIRT may provide a therapeutic benefit for PC with bladder invasion. Hence, we evaluated CIRT for PC with bladder invasion in terms of the safety and efficacy. Methods Between March 2010 and December 2016, a total of 1337 patients with nonmetastatic PC received CIRT at a total dose of 57.6 Gy (RBE) in 16 fractions over 4 weeks. Among them, seven patients who had locally advanced PC with bladder invasion were identified. Long-term androgen-deprivation therapy (ADT) was also administered to these patients. Adverse events were graded according to the Common Terminology Criteria for Adverse Event version 5.0. Results At the completion of our study, all the patients with cT4 PC were alive with a median follow-up period of 78 months. Grade 2 acute urinary disorders were observed in only one patient. Regarding late toxicities, only one patient developed grade 2 hematuria and urinary urgency. There was no grade 3 or worse toxicity, and gastrointestinal toxicity was not observed. Six (85.7%) patients had no recurrence or metastasis. One patient had biochemical and local failures 42 and 45 months after CIRT, respectively. However, the recurrent disease has been well controlled by salvage ADT. Conclusions Seven patients with locally advanced PC invading the bladder treated with CIRT were evaluated. Our findings seem to suggest positive safety and efficacy profiles for CIRT.
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Affiliation(s)
- Yuhei Miyasaka
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan.,Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Hidemasa Kawamura
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan. .,Gunma University Heavy Ion Medical Center, Maebashi, Japan.
| | - Hiro Sato
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan.,Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Nobuteru Kubo
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan.,Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Tatsuji Mizukami
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan.,Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Hiroshi Matsui
- Gunma University Heavy Ion Medical Center, Maebashi, Japan.,Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yoshiyuki Miyazawa
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kazuto Ito
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan.,Kurosawa Hospital, Takasaki, Japan
| | - Takashi Nakano
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan.,Quantum Medical Science Directorate, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Kazuhiro Suzuki
- Gunma University Heavy Ion Medical Center, Maebashi, Japan.,Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tatsuya Ohno
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan.,Gunma University Heavy Ion Medical Center, Maebashi, Japan
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